PARENTERAL NUTRITION-RELATED CHOLESTASIS IN POSTSURGICAL NEONATES - MULTIVARIATE-ANALYSIS OF RISK-FACTORS

The medical records of 74 neonates dependent on parenteral nutrition f or at least 21 days after emergency abdominal surgery (performed betwe en 1988 and 1992) were reviewed retrospectively. The role of enteral s tarvation, prematurity, composition and duration of parenteral nutriti on, and sepsis in the evolution of parenteral nutrition-related choles tasis was evaluated by multiple regression analysis. The most importan t factors for cholestasis were low gestational age (median, 34 weeks), early exposure to parenteral nutrition, and sepsis, Episodes of sepsi s were associated with a 30% increase in the bilirubin level. Enteral starvation and composition and the duration of parenteral nutrition so lutions did not correlate significantly with the development of choles tasis. Prevention of sepsis should be the priority in minimising chole stasis in postsurgical neonates who are dependent on parenteral nutrit ion. (C) 1996 by W.B. Saunders Company